NHS focus on targets undermining standards of care, doctors suggest in study

A majority of doctors in Scotland believe targets and finances are prioritised over quality of care, a new survey indicates.

Doctors’ organisation the BMA surveyed 999 doctors across Scotland and almost three-quarters (72%) said they think targets are given higher priority than the standard of care.

More than two-thirds (68%) thought the same of finances.

Around seven in 10 respondents (71%) said overall patient services have worsened in the past year, with 22% saying they have stayed the same and just 2% seeing improvement.

The vast majority (97%) believe NHS resources are inadequate and affect the quality of patients’ care, with 66% saying the impact is significant and 31% that it is slight.

The survey also highlighted concerns over workloads and bullying in the NHS.

More than nine out of 10 doctors (91%) said they are working over their allotted hours and just under half (47%) fear being “unfairly blamed” for medical errors caused by pressures or system failures at work.

Around nine in 10 (89%) doctors believe current staffing levels are not adequate to deliver quality patient care.

More than a third (38%) said bullying, undermining and harassment is an issue where they work but more than half (53%) would feel confident reporting this behaviour. Around a quarter (26%) would not.

BMA Scotland chairman Lewis Morrison said: “Our survey provides clear and worrying evidence that doctors in Scotland believe both national targets and finances are prioritised above the quality of patient care.

“This would indicate that the way our NHS is currently run is skewing priorities and not always putting the patient first.

“That simply cannot be right – everything our health services does should be about delivering the best care possible, and not simply meeting financial or waiting times targets, which often tell us little about the actual quality of care.”

He added: “It is clear from the results that there are simply not enough doctors to deliver the quality care we all strive to provide.”

Dr Morrison said the survey shows bullying and harassment of doctors is “far too prevalent” and said urgent steps need to be taken to promote a more positive culture in Scotland’s NHS.

Opposition politicians branded the survey “alarming” and “damning”.

Scottish Conservative health spokesman Miles Briggs said: “While finances and targets are of course extremely important, nothing should come before the welfare of patients.

“That’s what the NHS is meant to be about and it’s alarming to read this damning verdict from doctors.”

His Labour counterpart Monica Lennon said: “This is an utterly damning assessment of the condition of our health service from Scotland’s doctors.

“When seven in 10 doctors say that staffing and waiting times have worsened in the past year, the SNP Government needs to sit up and listen.”

Scottish Liberal Democrat health spokesman Alex Cole-Hamilton said: “This is an explosive report that ought to trigger some real soul-searching by the SNP.”

The Greens said the report is the latest sign the NHS “needs redesigned and better funded”.

The survey of BMA members was carried out from May 3 to June 4 and results published this week.

A Scottish Government spokesman said: “Since 2007 we have ensured that NHS funding has not only been protected, but has increased to record high levels. This has supported an increase of over 9% in NHS staffing levels – that’s an additional 12,000 whole time staff working in NHS Scotland.

“There have also been reductions in mortality rates, falls in healthcare associated infections, and Scotland’s A&E performance has been the best across the UK for the last three years and a half years.

“As a consequence of these improvements, delivered by committed health and care staff across the country, patient satisfaction has also increased to record highs.

“We have also increased the number of medical places in Scottish universities to a record high of 1,038, and are investing over £4 million over next 3 years in a comprehensive marketing and recruitment campaign.”